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민삼홍,김재환,소정섭,박지용,최성욱,이혜원,이재진 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.6
Purpose: The aim of this study was to investigate the effect of epidural dexamethasoneon analgesia and cytosolic phospholipase A2 (cPLA2) expression in the spinal cord in a rat formalin test. Materials and Methods: Epidural dexamethasone injectionwas performed to Sprague-Dawley rats with a 25 gauge needle under fluoroscopy. Following the epidural injection, a formalin induced pain behavior test was performed. Next, the spinal cords corresponding to L4 dorsal root ganglion was extracted to observe the cPLA2 expression. Results: There were no differences in pain response during phase I among the groups. The phase II pain response in 300 μg of epidural dexamethasone group decreased as compared to control, 30 μg of epiduraldexamethasone, 100 μg of epidural dexamethasone, and 300 μg of systemic dexamethasone groups. The expression of cPLA2 decreased in Rexed laminae I‒II in 300 μg of the epidural dexamethasone group compared with the ones in the control group. Conclusion: Taken together, these results suggest that 300 μg of epidural dexamethasone has an attenuating effect on the peripheral inflammatory tissue injury induced hyperalgesia and this effect is mediated through the inhibition of intraspinal cPLA2 expression and the primary site of action is the laminae I‒II of the spinal cord.
민삼홍,장성호,전세근,윤승주,박지용,신혜원 대한마취통증의학회 2010 Korean Journal of Anesthesiology Vol.59 No.-
Psychological factors play a significant role in the pain mechanism, and psychological approaches may be useful complements to traditional medical and surgical treatments in pain management. The authors report a case of recurrent severe posterior auricular pain caused by trigger points in the right sternocleidomastoid muscle and influenced by stressful psychological situations (e.g., family affairs, job loss) in a 50-year-old man.
Pleural effusion after microtia reconstructive surgery -A case report-
김연희,진남궁,임병건,민삼홍,신혜원,임춘학 대한마취통증의학회 2011 Korean Journal of Anesthesiology Vol.61 No.2
Microtia reconstructive surgery is usually a multi-stage repair procedure that involves the use of cartilage and skin grafts. Complications can arise at both ear reconstruction sites and cartilage donor sites. In particular, pneumothorax,atelectasis, chest scars, and chest deformities are known to be associated with the harvesting of costal cartilage. However, delayed pleural effusion can also develop. Our patient complained of a cough and chest pain at 5 days postoperatively, and pleural effusion was detected by chest radiography. However, thoracentesis was not performed and the effusion resolved spontaneously and completely.
차문호,김재환,엄지혜,이윤숙,김운영,박영철,민삼홍 연세대학교의과대학 2012 Yonsei medical journal Vol.53 No.2
Purpose: The aim of this prospective, double-blind, randomized study was to investigate the analgesic effects of low-dose ketamine on intravenous patient-controlled analgesia (IV-PCA) with fentanyl for pain control in pediatric patients following the Nuss procedure for pectus excavatum. Materials and Methods: Sixty pediatric patients undergoing the Nuss procedure were randomly assigned to receive fentanyl (Group F, n=30) or fentanyl plus ketamine (Group FK, n=30). Ten minutes before the end of surgery, following the loading dose of each solution, 0.5 μg/kg/hr of fentanyl or 0.5 μg/kg/hr of fentanyl plus 0.15 mg/kg/hr of ketamine was infused via an IV-PCA pump (basal rate, 1 mL/hr; bolus, 0.5 mL; lock out interval,30 min). Fentanyl consumption, pain score, ketorolac use, nausea/vomiting, ondansetron use, pruritus, respiratory depression, hallucination, dreaming, and parent satisfaction with pain control were measured throughout the 48 hours following surgery. Results: The pain scores, ketorolac use, and fentanyl consumption of Group FK were significantly lower than in Group F (p<0.05). The incidence of nausea/vomiting and ondansetron use in Group FK was significantly lower than in Group F (p<0.05). There were no reports of respiratory depression, hallucination or dreaming. Parent satisfaction with pain control was similar between the two groups. Conclusion: We concluded that low-dose ketamine added to IV-PCA with fentanyl after the Nuss procedure in pediatric patients can reduce pain scores, consumption of fentanyl, and incidence of nausea/vomiting without increasing side effects.